NPIMap

Organization Active NPI

Lifecare Solutions Palliative and Hospice LLC

  • Community Based Hospice Care Agency
  • Dublin, CA
National Provider Identifier
1841679610
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LIFECARE SOLUTIONS PALLIATIVE AND HOSPICE LLC
Practice address
7567 Amador Valley Blvd Ste 101
Dublin, CA 94568-2442
Phone
(510) 573-2523
Fax
(877) 217-7087
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Andro Bautista
Title
Ceo/Admin
Phone
(510) 573-2523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

7567 Amador Valley Blvd Ste 101
Dublin, CA 94568-2442

Mailing address

39675 Cedar Blvd
Suite 240 B
Newark, CA 94560-5489
Phone (510) 573-2523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160120001123 CA Part A Provider - Hospice 6608179981 Practice locations: Newark, CA

Hospice certification: CCN 751785

Legal name
LIFECARE SOLUTIONS PALLIATIVE AND HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 16, 2016
Last certification
Jul 10, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 6, 2015 in CA
Enrollment address
39675 Cedar Blvd
Ste 240B
Newark, CA 94560-8541

Care Compare: Hospice

Medicare Care Compare
Listed as
Lifecare Solutions Palliative and HospiceCCN 751785 ยท All quality measures
Ownership
For-Profit
Certified
Aug 16, 2016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

39675 Cedar Blvd
Ste 240B
Newark, CA 94560
Phone (510) 573-2523

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daisy Bautista Individual 5% Or Greater Direct Ownership Interest Sep 1, 2019 12.5%
W-2 Managing Employee Sep 1, 2019
Romulo Bautista Individual 5% Or Greater Direct Ownership Interest Sep 1, 2019 25%
W-2 Managing Employee Sep 1, 2019
Alejandria Bautista Individual 5% Or Greater Direct Ownership Interest Mar 1, 2018 50%
Andro N Bautista Individual 5% Or Greater Direct Ownership Interest Sep 1, 2019 12.5%
W-2 Managing Employee Sep 1, 2019

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1841679610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39675 CEDAR BLVD",
            "address_2": "SUITE 240 B",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945605489",
            "telephone_number": "510-573-2523",
            "fax_number": "187-721-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7567 AMADOR VALLEY BLVD STE 101",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682442",
            "telephone_number": "510-573-2523",
            "fax_number": "877-217-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE SOLUTIONS PALLIATIVE AND HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "ANDRO",
        "authorized_official_title_or_position": "CEO/ADMIN",
        "authorized_official_telephone_number": "510-573-2523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

Verify at the official NPI Registry.